CAJ | 학술논문

目的：观察复方鲜竹沥液联合沙美特罗/氟替卡松（舒利迭）治疗稳定期慢性阻塞性肺疾病（ COPD）的临床疗效。方法选取天津市第四中心医院呼吸科2012年12月—2013年6月经住院治疗或门诊就诊的稳定期COPD患者115例，随机分为A组（n＝38）、B组（n＝40）和C组（n＝37）。A组患者在常规治疗基础上单一给予舒利迭（50μg/250μg）治疗，B组患者在A组治疗基础上给予复方鲜竹沥液治疗，C组患者在常规治疗基础上单一给予舒利迭（50μg/500μg）治疗。比较治疗前、治疗后6及12个月3组患者6分钟步行距离（6MWD）、改良英国呼吸困难指数（ mMRC）分级、COPD评估测试（ CAT）评分及肺功能，并观察治疗期间两组患者不良反应发生情况。结果治疗前3组患者6MWD和CAT评分比较，差异无统计学意义（ P﹥0.05）。治疗后6及12个月B组和C组患者6MWD大于A组，CAT评分低于A组（P﹤0.05）；但B组和C组患者6MWD和CAT评分比较，差异无统计学意义（P﹤0.05）。治疗前和治疗后6个月3组患者mMRC分级、第一秒用力呼气末容积（ FEV1）及FEV1占预计值百分比（ FEV1％）比较，差异无统计学意义（P﹥0.05）。治疗后12个月B组和C组患者mMRC分级低于A组，FEV1和FEV1％高于A组（P﹤0.05）；但B组和C组患者mMRC分级、FEV1及FEV1％比较，差异无统计学意义（P﹥0.05）。3组患者不良反应发生率比较，差异无统计学意义（P﹥0.05）。结论复方鲜竹沥液联合舒利迭（50μg/250μg）治疗稳定期COPD患者安全有效，能有效改善患者临床症状、增加活动耐力、改善患者肺功能、提高患者生活质量，同时长期使用复方鲜竹沥液还能减少吸入激素使用量，是稳定期COPD患者的一种理想治疗选择。
목적：관찰복방선죽력액연합사미특라/불체잡송（서리질）치료은정기만성조새성폐질병（ COPD）적림상료효。방법선취천진시제사중심의원호흡과2012년12월—2013년6월경주원치료혹문진취진적은정기COPD환자115례，수궤분위A조（n＝38）、B조（n＝40）화C조（n＝37）。A조환자재상규치료기출상단일급여서리질（50μg/250μg）치료，B조환자재A조치료기출상급여복방선죽력액치료，C조환자재상규치료기출상단일급여서리질（50μg/500μg）치료。비교치료전、치료후6급12개월3조환자6분종보행거리（6MWD）、개량영국호흡곤난지수（ mMRC）분급、COPD평고측시（ CAT）평분급폐공능，병관찰치료기간량조환자불량반응발생정황。결과치료전3조환자6MWD화CAT평분비교，차이무통계학의의（ P﹥0.05）。치료후6급12개월B조화C조환자6MWD대우A조，CAT평분저우A조（P﹤0.05）；단B조화C조환자6MWD화CAT평분비교，차이무통계학의의（P﹤0.05）。치료전화치료후6개월3조환자mMRC분급、제일초용력호기말용적（ FEV1）급FEV1점예계치백분비（ FEV1％）비교，차이무통계학의의（P﹥0.05）。치료후12개월B조화C조환자mMRC분급저우A조，FEV1화FEV1％고우A조（P﹤0.05）；단B조화C조환자mMRC분급、FEV1급FEV1％비교，차이무통계학의의（P﹥0.05）。3조환자불량반응발생솔비교，차이무통계학의의（P﹥0.05）。결론복방선죽력액연합서리질（50μg/250μg）치료은정기COPD환자안전유효，능유효개선환자림상증상、증가활동내력、개선환자폐공능、제고환자생활질량，동시장기사용복방선죽력액환능감소흡입격소사용량，시은정기COPD환자적일충이상치료선택。
Objective To investigate the clinical effect of of fufang xianzhuli ye combined with salmeterol/fluticasone on stable chronic obstructive pulmonary disease( COPD). Methods A total of 115 stable COPD patients admitted to the Forth Central Hospital of Tianjin were selected from December 2012 to June 2013,and they were randomly divided into group A(n=38),B(n=40)and C(n=37). Three groups given routine treatment,and A group given salmeterol/fluticasone(50 μg/250 μg),B group given fufang xianzhuli ye combined with salmeterol/fluticasone(50 μg/250 μg),C group given salmeterol/fluticasone(50 μg/500 μg). Before treatment,6 months and 12 months after treatment,6-minute walk distance(6MWD), modified british medical research council( mMRC) grading,COPD assessment test( CAT) score and lung function among the three groups were compared, and incidence of adverse reactions during treatment was observed. Results No significant differences of 6MWD and CAT score was found among the three groups before treatment;6 months and 12 months after treatment, 6MWD of B group was longer than that of A group,and CAT score was lower(P ﹤0. 05),but no significant differences of 6MWD and CAT was found between groups B and C(P ﹥0. 05). No significant differences of mMRC grading,FEV1 and FEV1% was found among the three groups before treatment and 6 months after treatment ( P ﹥0. 05 );after 12 months of treatment,mMRC grading of groups B and C was lower than that of A group,respectively,and FEV1 ,FEV1% was higher, respectively(P﹤0. 05),but no significant differences of mMRC grading,FEV1 and FEV1% was found between groups B and C. No significant differences of incidence of adverse reactions was found among the three groups ( P ﹥0. 05 ). Conclusion Fufang xianzhuli ye combined with salmeterol/fluticasone(50 μg/250 μg) is effective and safe in treating stable COPD,can relieve the clinical symptoms, improve the activity endurance and the lung function, and is helpful to reduce inhaled corticosteroid dose by long-term usage,is an ideal choice of treating stable COPD.